Can next-generation antibiotics be found in medieval medicine recipes?

Brenda Lau, 02 May 2017

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The evolution of antibiotic-resistant microbes has sped up in the past decade, making the search for new drugs a constantly urgent matter. However, the search for new antibiotics has been slow and the drug discovery pipeline is currently stagnant.

Now, an estimated 700,000 people around the world die annually from drug-resistant infections but if the situation does not improve, experts say that such infections will kill 10 million individuals per year by 2050.

But all hope is not lost, as some medievalists and scientists are suggesting that there might be some clues in history to spur on the search for new antibiotics.

Medieval medicine thought to be backward

Medieval medicine has always been disregarded as the medieval time period has been thought to be void of science or reason.

According to Professor Hélène Cazes, director of the Medieval Studies program at the University of Victoria, the medieval period was generally culturally and intellectually rich, but the word "medieval" has been used to describe backwardness or barbarity as it was a period when tradition was valued over progress.

As such, there was no interest in looking into the Middle Ages for clues about medicine. But a team of medievalists, microbiologists, medicinal chemists, parasitologists, pharmacists and data scientists from multiple universities and countries have set out to prove that theory wrong.

Medieval medicine has been thought to be backward or barbaric.

The team called AncientBiotics, believe that with the help of modern technologies, it could be determined if medieval cures really worked. If they did, it could translate into a potential new drug to combat antibiotic-resistance in microbes.

As such, the team has compiled a database of medieval medical recipes and aims to decipher the patterns in medieval medical practice. Through employment of common tools of data science, such as network analysis, they hope to inform future laboratory research into the materials used to treat infection in the past.

Bald's eyesalve, a medieval recipe proven to work

In 2015, AncientBiotics published a pilot study on a 1,000-year old recipe called Bald's eyesalve from "Bald's Leechbook", an Old English medical text. The eyesalve was commonly used against a "wen," which may be translated as a sty or an infection of the eyelash follicle.

The bacterium Staphylococcus aureus is the common cause of modern styes and the antibiotic-resistant version, MRSA is resistant to many current antibiotics. Together, they are responsible for many severe and chronic infections.

Bald's eyesalve consists of wine, garlic, an allium species such as leek or onion, and ox gall. The recipe from medieval texts dictated that after the concoction of the salve, it must be left in a brass vessel for nine nights before use.

When AncientBiotics tried out the salve, the recipe was found to be a potent antistaphylococcal agent, which repeatedly killed established S. aureus biofilms in an in vitro infection model. In the chronic wounds of mice models, MRSA was also killed.

Can medieval methods point towards a possible clinical solution?

Compared with other traditional pharmacopeias in other parts of the world, such as China, medieval or premodern European medicine has been poorly studied, mainly due to the myth that the period is unworthy of study.

Certainly, there are medieval superstitions and treatments that should not be replicated today, such as purging a patient's body of pathogenic humors.

With the AncientBiotics' study however, it was found that by following the steps exactly specified by the Bald's eyesalve recipe, efficacy was improved drastically. This proved that there could be a methodology behind the medicines of medieval practitioners, based on a tradition of observation and experimentation.

Could the results of the Bald's eyesalve be a medieval recipe representative of others that treat infection? Was there a sort of "scientific" methodology for producing medically effective concoctions?

Further research may show that some medieval medicines could have been placebos or palliative aids rather than medications, but the Bald's eyesalve proved that actual "ancientbiotics" were used before modern antibiotics were used.

The potential of medieval medicine

Now the AncientBiotics is looking to decipher the medieval medical text, "Lylye of Medicynes", a 15th-century Middle English translation of the Latin "Lilium medicinae," first completed in 1305.

The text contains approximately 360 recipes of medical recipes. With this, the team aims to examine the patterns of treatment and the strength of ingredient relationships to determine if medieval medical recipes were driven by certain combinations of antimicrobial ingredients.

This would allow the possibility of new research into the antimicrobial agents contained in those ingredients on the molecular level.